The pressure to be an evidence based practitioner is increasing, and gaining more and more momentum globally, even though there are still some “dinosaurs”, as physiotherapist Adam Meakins has called them, that resist this change.
“The dinosaurs I am referring to are the many iconic, influential and idolised clinicians and researchers who, despite a new era in understanding pain and growing evidence of the biopsychosocial model, still stubbornly refuse to change their methods or mind-set, and continue to promote and teach outdated methods of assessment and treatment.” Meakins 2016
However, there are very few health professionals who have full access to all the relevant scientific journals and databases in their field. This is a big problem because the rest are therefore effectively prevented from taking advantage of the goldmine of scientific knowledge, and to use this research to better the care of their clients.
A solution to this could be to sign up for a yearly membership for journals like the European Journal of Pain or The Journal of the American Physical Therapy Association. The cost of this is between 210-550 USD for a year. But while this is a very good start, this will only provide a small fraction of the research that is relevant in the physiotherapy field.
A more balanced and complete view of the research would draw from multiple journals, like for example: European Journal of Pain, PAIN (Journal of the IASP), og Journal of the American Physical Therapy Association, British Journal of Sports Medicine (BJSM), Physical Therapy in Sport, Archives of Physical Medicine and Rehabilitation, The Clinical Journal of Pain, The New England Journal of Medicine (NEJM), British Medical Journal (BMJ), The American Journal of Sports Medicine, and PLOS Medicine. These are some of the journals that are the knowledge base for my own courses, lectures and practice.
To have a yearly membership to all of these journals would be a very costly affair. Most physiotherapy students do, however, through their university have access to the most important journals in their respected field. So for all non-physiotherapy students or working physiotherapists without access to multiple journals this represents a real problem.
The pressure on physiotherapists to become evidence based is increasingly evident, and it could be viewed as an essential skill of their practice, to paraphrase Prof. Glasziou from the editorial below. Applying research findings to patient care, is as essential as skills with a stethoscope. He further states that:
“Individual practitioners therefore need to be able to find and use evidence themselves — a 21st century clinician who cannot critically read a study is as unprepared as one who cannot take a blood pressure or examine the cardiovascular system.” Glasziou et al. 2008
So how do we solve this problem that physiotherapist without access to multiple journals do have? There are actually several ways to get scientific papers for free.
Some companys, researchers or universitys make PDFs of specific papers available. Below are my 5 “secrets” to get free scientific papers. To use a movie quote to illustrate my experience: “60% of the time, it works every time”.
- Write PDF and the title of the paper in Google. Like this: “pdf Reconceptualizing pain according to modern pain science” but without the “”.
- Use Google Scholar and do a search on the title. Like this: “Beliefs about back pain: The confluence of client, clinician and community.”
- Write an email to the lead author. Their email address is usually found in the university profile. Very often you will get the papers within a few days.
- Use ResearchGate. ResearchGate is a site for scientists and researchers to share papers, ask and answer questions, and find collaborators.
- Write to a friend that you know has PubMed access, and ask him to send you a PDF of the paper.
Another option is to use a Russian hacker site, but this is illegal and you could be held liable for charges. I hope the advice helps, and happy journeys into this essential part of our fantastic profession.
“The skills needed to find potentially relevant studies quickly and reliably, to separate the wheat from the chaff, and to apply sound research findings to patient care have today become as essential as skills with a stethoscope.” Glasziou et al. 2008
Here, near the end of the article, I feel the need to mention another problem. The next problem is when you do have accesses to multiple journals: What do you choose to read in this tsunami of research that is being published every year?
My next post will be about this, namely what are the first and essential papers you should read.
Glasziou P, Burls A, Gilbert R. Evidence based medicine and the medical curriculum. BMJ. 2008 Sep 24;337:a1253. doi: 10.1136/bmj.a1253.
Meakins A. Dinosaurs among us causing chaos and confusion. Br J Sports Med. 2016 Apr;50(7):384-5. doi: 10.1136/bjsports-2015-095282. Epub 2015 Aug 3.
About the author:
Lars Avemarie Lars is a personal trainer, physiotherapy student and he lectures internationally. Lars has a unique blend of knowledge about pain science, neuroscience, physiotherapy, evidence-based practice, exercise science, rehabilitation, sleep research and critical thinking, the latter including expertise in argumentation theory and informal logic. Lars has worked almost a decade full-time in the healthcare industry.